Renaissance Healthcare LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

RENAISSANCE HEALTHCARE LLC

Practice address

419 Airport Rd
Griffin, GA 30224-4834

Phone

(770) 227-8636

Fax

(770) 227-1450

NPI assigned

Jul 19, 2019

Last updated

Sep 17, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shlomo Heller

Title

Member

Phone

(470) 737-0111

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1457904310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 AIRPORT RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244834",
            "telephone_number": "770-227-8636",
            "fax_number": "770-227-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 AIRPORT RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244834",
            "telephone_number": "770-227-8636",
            "fax_number": "770-227-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "470-737-0111"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Griffin, GA
• Providers in Griffin, GA by specialty
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.